I Pa Jaiya Prakaash have purchased health insurance policy of Rs.3, 00, 000 and top up policy Rs.15, 00, 000 in MaxBupa with corona coverage scheme for my family.on may 2021 myself, my wife , and my two children tested covid positive and got admitted in their approved hospital for treatment.At the time of admission we processed for cashless claim, since our claim was first case for hospital with max bupa, doctor send the details without admission summary. So they denied my cashless claim and I paid the bill amount during discharge and my insurance agent asked me to claim that amount through reimbursement.
After that with admission summary my wife got Rs.2, 05, 328 instead of Rs.2, 99, 427 (Total bill amount Rs.3, 45, 685 after deducting Rs. 46, 258 , eligible amount for claim approval Rs.2, 99, 427). they rejected my wife’s remaining bill amount of Rs.94099 without considering the topup policy.by only considering Rs.3, 00, 000 policy and without considering top-up policy of Rs 15, 00, 000 they rejected as limit exceeded.My wife discharged from that hospital by paying the remaining bill amount by me and got admitted to another hospital for further treatment and she died, and that bill amount Rs.50690 was also paid by me and the insurance agent asked me to claim my wife’s bill amount of Rs.94099+Rs.50690 through reimbursement.
I started the process of reimbursement for my bill and my wife’s bill amount in the month of May and it’s been 10 months, I didn’t get the claim amount. I have send the bill details to them through online and also through courier. The person responsible for the claim changes frequently and every time the new person starting the process from the first and till now I didn’t get the claim amount.
So by taking the policy of Rs 18, 00, 000 in max bupa I can’t even claim less than Rs 5, 00, 000.
For further queries contact Pa Jaiya Prakaash mobile no +91 93859 89702